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Acceptability of short message service (SMS) as a tool for malaria treatment adherence in the Brazilian Amazon: a qualitative study SMS (SMS Amazon
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Rodovalho, Sheila

; Dias, Ádila Liliane Barros

; Ade, Maria Paz

; Saint-Gerons, Diego Macias

; Castro, Jose Luis

; Beratarrechea, Andrea

; Murta, Felipe Leão Gomes

; Santos, Alicia Cacau Patrine dos

; Marques, Leonardo Lincoln Gomes

; Sampaio, Vanderson Souza

; Baia-da-Silva, Djane Clarys

; Monteiro, Wuelton Marcelo

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0616-2022

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Malaria is one of the leading causes of morbidity worldwide, and patient adherence to prescribed antimalarials is essential for effective treatment. Methods: This cross-sectional study, with in-depth telephone interviews, analyzed participants’ perceptions of short message service (SMS) in adherence to treatment. Results: Five thematic categories emerged: decreased forgetfulness, the novelty of the tool, easy-to-understand language, the impact of SMS messages during treatment, and suggestions for improvement and complaints. Conclusions: SMS could assist patients in adhering to prescribed antimalarials. Background worldwide treatment Methods crosssectional cross sectional study indepth depth interviews participants (SMS Results emerged forgetfulness tool easytounderstand easy understand language complaints Conclusions

https://doi.org/10.1590/0037-8682-0616-2022

Prediction of malaria using deep learning models: A case study on city clusters in the state of Amazonas, Brazil, from 2003 to 2018
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Barboza, Matheus Félix Xavier

; Monteiro, Kayo Henrique de Carvalho

; Rodrigues, Iago Richard

; Santos, Guto Leoni

; Monteiro, Wuelton Marcelo

; Figueira, Elder Augusto Guimaraes

; Sampaio, Vanderson de Souza

; Lynn, Theo

; Endo, Patricia Takako

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0420-2021

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Malaria is curable. Nonetheless, over 229 million cases of malaria were recorded in 2019, along with 409,000 deaths. Although over 42 million Brazilians are at risk of contracting malaria, 99% percent of all malaria cases in Brazil are located in or around the Amazon rainforest. Despite declining cases and deaths, malaria remains a major public health issue in Brazil. Accurate spatiotemporal prediction of malaria propagation may enable improved resource allocation to support efforts to eradicate the disease. Methods: In response to calls for novel research on malaria elimination strategies that suit local conditions, in this study, we propose machine learning (ML) and deep learning (DL) models to predict the probability of malaria cases in the state of Amazonas. Using a dataset of approximately 6 million records (January 2003 to December 2018), we applied k-means clustering to group cities based on their similarity of malaria incidence. We evaluated random forest, long-short term memory (LSTM) and dated recurrent unit (GRU) models and compared their performance. Results: The LSTM architecture achieved better performance in clusters with less variability in the number of cases, whereas the GRU presents better results in clusters with high variability. Although Diebold-Mariano testing suggested that both the LSTM and GRU performed comparably, GRU can be trained significantly faster, which could prove advantageous in practice. Conclusions: All models showed satisfactory accuracy and strong performance in predicting new cases of malaria, and each could serve as a supplemental tool to support regional policies and strategies.

https://doi.org/10.1590/0037-8682-0420-2021

Effect of weekly versus daily primaquine on Plasmodium vivax malaria recurrences: A real-life cohort study
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Brito-Sousa, Jose Diego

; Phanor, Jeffe

; Balieiro, Patricia Carvalho da Silva

; Silva-Neto, Alexandre Vilhena

; Cordeiro, Jady Shayenne Mota

; Vitor-Silva, Sheila

; Mendes, Maxwell

; Sampaio, Vanderson Souza

; Melo, Gisely Cardoso de

; Lacerda, Marcus

; Monteiro, Wuelton

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0738-2021

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Although primaquine (PQ) is indicated for G6PD-deficient patients, data on weekly PQ use in Brazil are limited. Methods: We aimed to investigate malaria recurrences among participants receiving daily and weekly PQ treatments in a real-life setting of two municipalities in the Amazon between 2019 and 2020. Results: Patients receiving weekly PQ treatment had a lower risk of recurrence than those receiving daily PQ treatment (risk ratio: 0.62, 95% confidence interval: 0.41-0.94), using a model adjusted for study site. Conclusions: Weekly PQ use did not increase the risk of malaria recurrence. Further studies with larger populations are warranted.

https://doi.org/10.1590/0037-8682-0738-2021

Prevalence and force of Plasmodium vivax blood-stage infection and associated clinical malaria burden in the Brazilian Amazon
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Monteiro, Wuelton

; Karl, Stephan

; Kuehn, Andrea

; Almeida, Anne

; White, Michael

; Vitor-Silva, Sheila

; Melo, Gisely

; Brito-Sousa, Jose Diego

; Baia-da-Silva, Djane Clarys

; Silva-Neto, Alexandre Vilhena

; Sampaio, Vanderson

; Bassat, Quique

; Felger, Ingrid

; Mueller, Ivo

; Lacerda, Marcus

Memórias do Instituto Oswaldo Cruz

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2022, Volume 117 elocation e210330

Abstract: En | Text: En | PDF: En

BACKGROUND Understanding the epidemiology of malaria through the molecular force of the blood-stage infection of Plasmodium vivax (molFOB) may provide a detailed assessment of malaria transmission. OBJECTIVES In this study, we investigated risk factors and spatial-temporal patterns of incidence of Plasmodium infection and clinical malaria episodes in three peri-urban communities of Manaus, Western Brazilian Amazon. METHODS Monthly samples were collected in a cohort of 1,274 individuals between April 2013 and March 2014. DNA samples were subject to Plasmodium species. molFOB was calculated by counting the number of genotypes observed on each visit, which had not been present in the preceding two visits and adjusting these counts by the respective times-at-risk. FINDINGS Respectively, 77.8% and 97.2% of the population remained free of P. vivax and P. falciparum infection. Expected heterozygosity for P. vivax was 0.69 for MSP1_F3 and 0.86 for MS2. Multiplicity of infection in P. vivax was close to the value of 1. The season was associated with P. vivax positivity [adjusted hazard ratio (aHR) 2.6 (1.9-5.7)] and clinical disease [aHR 10.6 (2.4-47.2)]. P. falciparum infection was associated with previous malarial episodes [HR 9.7 (4.5-20.9)]. Subjects who reported possession of a bed net [incidence rate ratio (IRR) 1.6 (1.2-2.2)] or previous malaria episodes [IRR 3.0 (2.0-4.5)] were found to have significantly higher P. vivax molFOB. MAIN CONCLUSIONS Overall, P. vivax infection prevailed in the area and infections were mostly observed as monoclonal. Previous malaria episodes were associated with significantly higher P. vivax molFOB.

https://doi.org/10.1590/0074-02760210330

Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil
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Pileggi, Gecilmara Salviato

; Ferreira, Gilda Aparecida

; Gomides Reis, Ana Paula Monteiro

; Reis Neto, Edgard Torres

; Abreu, Mirhelen Mendes

; Albuquerque, Cleandro Pires

; Araújo, Nafice Costa

; Bacchiega, Ana Beatriz

; Bianchi, Dante Valdetaro

; Bica, Blanca

; Bonfa, Eloisa Duarte

; Borba, Eduardo Ferreira

; Brito, Danielle Christinne Soares Egypto

; Duarte, Ângela Luzia Branco Pinto

; Santo, Rafaela Cavalheiro Espírito

; Fernandes, Paula Reale

; Guimarães, Mariana Peixoto

; Gomes, Kirla Wagner Poti

; Kakehasi, Adriana Maria

; Klumb, Evandro Mendes

; Lanna, Cristina Costa Duarte

; Marques, Claudia Diniz Lopes

; Monticielo, Odirlei André

; Mota, Licia Maria Henrique

; Munhoz, Gabriela Araújo

; Paiva, Eduardo Santos

; Pereira, Helena Lucia Alves

; Provenza, José Roberto

; Ribeiro, Sandra Lucia Euzébio

; Rocha Junior, Laurindo Ferreira

; Sampaio, Camila Santana Justo Cintra

; Sampaio, Vanderson Souza

; Sato, Emília Inoue

; Skare, Thelma

; de Souza, Viviane Angelina

; Valim, Valeria

; Lacerda, Marcus Vinícius Guimarães

; Xavier, Ricardo Machado

; Pinheiro, Marcelo Medeiros

Advances in Rheumatology

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2021, Volume 61 elocation 60

Abstract: En | Text: En | PDF: En

Abstract Background: There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. Methods: This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann-Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. Results: From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren’s syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03-2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19-6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31-3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46-0.98). Conclusion: Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR - 9KTWX6).

https://doi.org/10.1186/s42358-021-00217-0 22 downloads

Fatores associados à mortalidade por causas inespecíficas e mal definidas no estado do Amazonas, Brasil, de 2006 a 2012
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Balieiro, Patrícia Carvalho da Silva

; Silva, Leila Cristina Ferreira da

; Sampaio, Vanderson de Souza

; Monte, Eyrivania Xavier do

; Pereira, Edylene Maria dos Santos

; Queiroz, Lais Araújo Ferreira de

; Saraiva, Rita

; Costa, Antonio José Leal

Ciência & Saúde Coletiva

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jan 2020, Volume 25 N. 1 Pages 339 - 352

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivou-se investigar fatores associados à mortalidade por causas inespecíficas e mal definidas no estado do Amazonas (AM). Desenvolveu-se um estudo seccional incluindo 90.439 registros de óbitos não fetais, com residência e ocorrência no AM entre 2006 e 2012. Foram estimadas razões de chances de causas inespecíficas e mal definidas por meio de regressão logística multinomial hierárquica. A proporção de causas mal definidas e inespecíficas foi, respectivamente, 16,6% e 9,1%. A ocorrência de causas mal definidas diminuiu ao longo dos anos e a de causas inespecíficas somente no último biênio. As causas inespecíficas associaram-se com residência e ocorrência do óbito fora da capital, via pública, sexo feminino, dos 10 aos 49 anos, cor parda e quando atestadas por legistas. As causas mal definidas associaram-se com residência e ocorrência fora da capital, em domicílios, a partir de 40 anos, cor não branca, não ser solteiro, baixa escolaridade, assistência médica e falta de informação sobre o atestante. A mortalidade por causas mal definidas e inespecíficas no AM declinou entre 2006 e 2012, associando-se às dimensões espacial e temporal, fatores demográficos, socioeconômicos e à assistência médica na ocasião do óbito.

Abstract This study aimed to investigate factors associated with unspecified and ill-defined causes of death in the State of Amazonas (AM), Brazil. This is a cross-sectional study on 90,439 non-fetal deaths of residents in AM from 2006 to 2012. The hierarchical multinomial logistic model estimated odds ratios of unspecified and ill-defined causes of death. Ill-defined and unspecified causes of death proportional mortality was, respectively, 16.6% and 9.1%. Ill-defined causes showed a decreasing trend over the years, while unspecified causes only decreased in the last two years. Unspecified causes of death were associated with residence and death outside the capital, public roads, female gender, age group 10-49 years, brown skin color and when certified by forensic doctors. Ill-defined causes of death were associated with residence and occurrence outside capital, at home, ages 40 years and older, non-whites, not being single, low schooling, under medical care and when examiner was unknown. Ill-defined and unspecified cause mortality in the State of Amazonas decreased between 2006 and 2012 in AM and was associated with space and time, demographic and socioeconomic factors and medical care at the moment of death.

https://doi.org/10.1590/1413-81232020251.27182017

Fatores associados à mortalidade por causas inespecíficas e mal definidas no estado do Amazonas, Brasil, de 2006 a 2012
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Balieiro, Patrícia Carvalho da Silva

; Silva, Leila Cristina Ferreira da

; Sampaio, Vanderson de Souza

; Monte, Eyrivania Xavier do

; Pereira, Edylene Maria dos Santos

; Queiroz, Lais Araújo Ferreira de

; Saraiva, Rita

; Costa, Antonio José Leal

Ciência & Saúde Coletiva

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jan 2020, Volume 25 N. 1 Pages 339 - 352

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232020251.27182017 1331 downloads

Economic model for obtaining cyclodextrins from commercial cgtase
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Koga, Luciana Numata

; Fenelon, Vanderson Carvalho

; Miyoshi, Juliana Harumi

; Moriwaki, Cristiane

; Wessel, Kamila Byanca Baldin

; Mangolim, Camila Sampaio

; Matioli, Graciette

Brazilian Journal of Pharmaceutical Sciences

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2020, Volume 56 elocation e18993

Abstract: En | Text: En | PDF: En

A repetitive batch process was employed followed by membrane ultrafiltration system to produce low-cost cyclodextrins (CDs) using commercial enzymes Toruzyme® cyclomaltodextrin glucanotransferase (CGTase) and its kinetic parameters were determined. The ultrafiltration system enabled the removalof inhibitory products from the reaction medium, allowing the enzyme to be recovered for reuse. A 10 kDa membrane was used to separate the different CDs produced by the CGTase. The substrates evaluated were maltodextrin, corn starch and cassava starch at 5, 10 and 15% (w/V), in the presence and absence of 10% (V/V) ethanol. After reaction for 132 h, 10% (w/V) cassava starch in the presence of ethanol provided the best results with 32.1 mg/mL of β-CD. Maximum production occurred after 72 h of reaction, with a yield of 87.4% of β-CD and an α-CD, β-CD and γ-CD production ratio of 1:1:0.08 g, respectively. When eight repetitive batches of 72 h followed by ultrafiltration and crystallization of β-CD were performed, 2.1 g of precipitate was obtained with a purity of 67.6% β-CD. The supernatant from the crystallization process was lyophilized and resulted in 35.3% α-CD. The developed model can be used industrially for the production of low cost CDs from easily obtained raw material.

https://doi.org/10.1590/s2175-97902020000118993 181 downloads

#StayHome: Monitoring and benchmarking social isolation trends in Caruaru and the Região Metropolitana do Recife during the COVID-19 pandemic
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Endo, Patricia Takako

; Silva, Ivanovitch

; Lima, Luciana

; Bezerra, Leonardo

; Gomes, Rafael

; Ribeiro-Dantas, Marcel

; Alves, Gisliany

; Monteiro, Kayo Henrique de Carvalho

; Lynn, Theo

; Sampaio, Vanderson de Souza

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20200271

Abstract: En | Text: En | PDF: En

Abstract: This technical report presents information related to the Social Isolation Index (SII) of the city of Caruaru, Pernambuco, Brazil. The data was provided by In Loco, a technology startup that has collected the movement of around 60 million Brazilians through cell phone location.

https://doi.org/10.1590/0037-8682-0271-2020 898 downloads

10.

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Adults
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Barban, Juliana Bernardo

; Simões, Belinda Pinto

; Moraes, Bruna Del Guerra de Carvalho

; Anunciação, Cássia Rehem da

; Rocha, Cristiane Santos da

; Pintor, Daniela Cristina Querino

; Guerra, Daiane Cristina

; Silva, Deise Andrade

; Brandão, Edith de Castro Martins

; Kerbauy, Fábio

; Pires, Fernanda Ramos de Oliveira

; Morais, Graciele Lima

; Schmidt Filho, Jayr

; Sicchieri, Juliana Maria Faccioli

; Barroso, Karine Sampaio Nunes

; Viana, Luciana Verçoza

; Rocha, Mariana Hollanda Martins da

; Guimarães, Maysa Penteado

; Lazzari, Natalia Leonetti Couto

; Hamerschlak, Nelson

; Ramos, Patricia

; Gomes, Plinio Nascimento

; Mendonça, Priscila da Silva

; Oliveira, Raquel Candido de

; Scomparim, Renata Corrêa

; Chiattone, Ricardo

; Diez-Garcia, Rosa Wanda

; Cardenas, Thaís de Campos

; Miola, Thais Manfrinato

; Costa, Thalita Cristina de Mello

; Rocha, Vanderson

; Pereira, Andrea Z

einstein (São Paulo)

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2020, Volume 18 elocation AE4530

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O estado nutricional do paciente submetido ao transplante de células-tronco hematopoéticas é considerado fator de risco independente, podendo influenciar na qualidade de vida e na tolerância ao tratamento proposto. O comprometimento do estado nutricional durante o transplante de células-tronco hematopoéticas ocorre principalmente devido aos efeitos adversos decorrentes do condicionamento ao qual o paciente é submetido. Desta forma, a adequada avaliação nutricional e o acompanhamento durante o transplante de células-tronco hematopoéticas tornam-se imprescindíveis. Com o objetivo de salientar a importância do estado nutricional e da composição corporal durante o tratamento, bem como as principais características relacionadas à avaliação nutricional do paciente, o Consenso Brasileiro de Nutrição em Transplante de Células-Tronco Hematopoiéticas: Adulto foi elaborado visando uniformizar e atualizar a Terapia Nutricional nesta área. Com a participação de nutricionistas, nutrólogos e hematologistas de 15 centros brasileiros referências em transplante de células-tronco hematopoéticas

ABSTRACT The nutritional status of patients submitted to hematopoietic stem cell transplant is considered an independent risk factor, which may influence on quality of life and tolerance to the proposed treatment. The impairment of nutritional status during hematopoietic stem cell transplant occurs mainly due to the adverse effects resulting from conditioning to which the patient is subjected. Therefore, adequate nutritional evaluation and follow-up during hematopoietic stem cell transplant are essential. To emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to the nutritional assessment of the patient, the Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplant: Adults was prepared, aiming to standardize and update Nutritional Therapy in this area. Dietitians, nutrition physicians and hematologists from 15 Brazilian centers thar are references in hematopoietic stem cell transplant took part.

https://doi.org/10.31744/einstein_journal/2020ae4530 3888 downloads

11.

Do climate changes alter the distribution and transmission of malaria? Evidence assessment and recommendations for future studies
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Cella, Wilsandrei

; Baia-da-Silva, Djane Clarys

; Melo, Gisely Cardoso de

; Tadei, Wanderli Pedro

; Sampaio, Vanderson de Souza

; Pimenta, Paulo

; Lacerda, Marcus Vinicius Guimarães

; Monteiro, Wuelton Marcelo

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20190308

Abstract: En | Text: En | PDF: En

Abstract Malaria, a mosquito-borne infectious disease, is considered a significant global health burden. Climate changes or different weather conditions may impact infectious diseases, specifically those transmitted by insect vectors and contaminated water. Based on the current predictions for climate change associated with the increase in carbon dioxide concentrations in the atmosphere and the increase in atmospheric temperature, the Intergovernmental Panel on Climate Change predicts that in 2050, malaria may threaten some previously unexposed areas worldwide and cause a 50% higher probability of malaria cases. Climate-based distribution models of malaria depict an increase in the geographic distribution of the disease as global environmental temperatures and conditions worsen. Researchers have studied the influence of changes in climate on the prevalence of malaria using different mathematical models that consider different variables and predict the conditions for malaria distribution. In this context, we conducted a mini-review to elucidate the important aspects described in the literature on the influence of climate change in the distribution and transmission of malaria. It is important to develop possible risk management strategies and enhance the surveillance system enhanced even in currently malaria-free areas predicted to experience malaria in the future.

https://doi.org/10.1590/0037-8682-0308-2019 3744 downloads

12.

Current vector control challenges in the fight against malaria in Brazil
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Baia-da-Silva, Djane Clarys

; Brito-Sousa, José Diego

; Rodovalho, Sheila Rodrigues

; Peterka, Cassio

; Moresco, Gilberto

; Lapouble, Oscar Martín Mesones

; Melo, Gisely Cardoso de

; Sampaio, Vanderson de Souza

; Alecrim, Maria das Graças Costa

; Pimenta, Paulo

; Lima, José Bento Pereira

; Lacerda, Marcus Vinícius Guimarães de

; Monteiro, Wuelton Marcelo

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20180542

Abstract: En | Text: En | PDF: En

Abstract In Brazil, malaria is an important public health problem first reported in 1560. Historically, fluctuations in malaria cases in Brazil are attributed to waves of economic development; construction of railroads, highways, and hydroelectric dams; and population displacement and land occupation policies. Vector control measures have been widely used with an important role in reducing malaria cases. In this review article, we reviewed the vector control measures established in the Brazilian territory and aspects associated with such measures for malaria. Although some vector control measures are routinely used in Brazil, many entomological and effectiveness information still need better evidence in endemic areas where Plasmodium vivax predominates. Herein, we outlined some of the needs and priorities for future research: a) update of the cartography of malaria vectors in Brazil, adding molecular techniques for the correct identification of species and complexes of species; b) evaluation of vector competence of anophelines in Brazil; c) strengthening of local entomology teams to perform vector control measures and interpret results; d) evaluation of vector control measures, especially use of insecticide-treated nets and long-lasting insecticidal nets, estimating their effectiveness, cost-benefit, and population acceptance; e) establishment of colonies of malaria vectors in Brazil, i.e., Anopheles darlingi, to understand parasite-vector interactions better; f) study of new vector control strategies with impacts on non-endophilic vectors; g) estimation of the impact of insecticide resistance in different geographical areas; and h) identification of the relative contribution of natural and artificial breeding sites in different epidemiological contexts for transmission.

https://doi.org/10.1590/0037-8682-0542-2018 3986 downloads

13.

Overview of artemisinin effectiveness during outset years of its implementation in the western Brazilian Amazon
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Pinto, Raquel de Medeiros

; Sampaio, Vanderson de Souza

; de Melo, Gisely Cardoso

; Alecrim, Maria das Graças Costa

; Mattos, Karine

; Perdomo, Renata Trentin

; Cordeiro, Sabrine da Costa

; Parente, Ana Flávia Alves

; de Carvalho, Lídia Raquel

; Mendes, Rinaldo Pôncio

; Lacerda, Marcus Vinícius Guimarães

; Monteiro, Wuelton Marcelo

; Weber, Simone Schneider

Memórias do Instituto Oswaldo Cruz

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2019, Volume 114 elocation e190075

Abstract: En | Text: En | PDF: En

BACKGROUND The elimination of malaria depends on the blocking of transmission and of an effective treatment. In Brazil, artemisinin therapy was introduced in 1991, and here we present a performance overview during implementation outset years. METHODS It is a retrospective cohort (1991 to 2002) of patients treated in a tertiary centre of Manaus, with positive microscopic diagnosis of Plasmodium falciparum malaria, under treatment with using injectable or rectal artemisinin derivatives, and followed over 35-days to evaluate parasite clearance, death and recurrence. FINDINGS This cohort outcome resulted 97.6% (1554/1593) of patients who completed the 35-day follow-up, 0.6% (10/1593) of death and 1.8% (29/1593) of follow-up loss. All patients that died and those that presented parasitaemia recurrence had pure P. falciparum infections and received monotherapy. Considering patients who completed 35-day treatment, 98.2% (1527/1554) presented asexual parasitaemia clearance until D4 and 1.8% (27/1554) between D5-D10. It is important to highlight that had no correlation between the five treatment schemes and the sexual parasite clearance. Finally, it is noteworthy that we were able to observe also gametocytes carriage during all follow-up (D0-D35). MAIN CONCLUSIONS Artemisinin derivatives remained effective in the treatment of falciparum malaria during first 12-years of use in north area of Brazil.

https://doi.org/10.1590/0074-02760190075 1863 downloads

14.

Delayed healthcare and secondary infections following freshwater stingray injuries: risk factors for a poorly understood health issue in the Amazon
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Sachett, Jacqueline de Almeida Gonçalves

; Sampaio, Vanderson Souza

; Silva, Iran Mendonça

; Shibuya, Akemi

; Vale, Fábio Francesconi

; Costa, Fabiano Peixoto

; Pardal, Pedro Pereira de Oliveira

; Lacerda, Marcus Vinícius Guimarães

; Monteiro, Wuelton Marcelo

Revista da Sociedade Brasileira de Medicina Tropical

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oct 2018, Volume 51 N. 5 Pages 651 - 659

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION This study aimed to describe the profile of freshwater stingray injuries in the State of Amazonas, Brazilian Amazon, and to identify the associated risk factors for secondary infections. METHODS This cross-sectional study used surveillance data from 2007 to 2014 to identify factors associated with secondary infections from stingray injuries. RESULTS A total of 476 freshwater stingray injuries were recorded, with an incidence rate of 1.7 cases/100,000 person/year. The majority of injuries were reported from rural areas (73.8%) and 26.1% were related to work activities. A total of 74.5% of patients received medical assistance within the first 3 hours of injury. Secondary infections and necrosis were observed in 8.9% and 3.8%, respectively. Work-related injuries [odds ratio (OR) 4.1, confidence interval (CI); 1.87-9.13] and >24 hours from a sting until receiving medical care (OR; 15.5, CI; 6.77-35.40) were independently associated with the risk of secondary bacterial infection. CONCLUSIONS: In this study, work-related injuries and >24 hours from being stung until receiving medical care were independently and significantly associated with the risk of secondary infection. The frequency of infection following sting injuries was 9%. The major factor associated with the risk of secondary bacterial infection was a time period of >24 hours from being stung until receiving medical care.

https://doi.org/10.1590/0037-8682-0356-2017 1142 downloads

15.

Hymenoptera stings in Brazil: a neglected health threat in Amazonas State
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Costa, Allyson Guimarães

; Chaves, Bárbara Aparecida

; Murta, Felipe Leão Gomes

; Sachett, Jacqueline Almeida Gonçalves

; Sampaio, Vanderson Souza

; Silva, Vanessa Costa

; Monteiro, Wuelton Marcelo

Revista da Sociedade Brasileira de Medicina Tropical

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feb 2018, Volume 51 N. 1 Pages 80 - 84

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: Hymenoptera injuries are commonly caused by stinging insects. In Amazonas state, Brazil, there is no information regarding distribution, profile, and systemic manifestations associated with Hymenoptera injuries. METHODS: This study aimed to identify risk factors for systemic manifestation using the Brazilian Notifiable Diseases Surveillance System (2007 to 2015). RESULTS: Half of Hymenoptera injuries were caused by bee stings. Hymenoptera injuries were concentrated in Manaus, and 13.36% of cases displayed systemic signs. Delayed medical assistance (4 to 12 hours) presented four times more risk for systemic manifestations. CONCLUSIONS: Simple clinical observations and history of injury are critical information for prognostic improvement.

https://doi.org/10.1590/0037-8682-0109-2017 1464 downloads

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